A 78-year-old patient with end-stage heart failure is admitted with worsening symptoms. He has a legally valid advance directive specifying 'Do Not Resuscitate' (DNR) and 'Do Not Intubate' (DNI). His daughter insists that 'everything possible' be done, stating she cannot bear to lose him. What is the physician's most appropriate initial action?
✓ Correct Answer: Option C
The physician's primary responsibility is to honor the patient's autonomous decisions as expressed in their advance directive. The most appropriate initial step is to engage in open communication with the daughter to explain the patient's wishes, prognosis, and the ethical principles guiding care.